Jacksonville partnership helps families navigate legal issues complicating children's medical care

March 27-- Mar. 27--One September day in 2017, the foundation of Marckly Charles' world collapsed.

His widowed mother died at age 50 of a heart ailment, leaving him head of the household and parent figure for his three younger siblings. He had no relatives to help out.

Charles was 20.

"It was tough," he said. "I didn't know where to go or who to reach out to."

Charles had a longtime goal -- becoming a nurse -- which kept him centered after his mother's death. He and his eldest sister worked, and he paid the mortgage and other bills and kept the family steered straight ahead. But he encountered legal obstacles when he tried on his own to gain custody of his younger siblings, get his mother's estate settled and obtain public benefits for the family. He started saving money for an attorney to help him navigate.

A few months later, his brother suffered a serious leg injury playing high school football. Doctors at Nemours Children's Specialty Care-Jacksonville said he needed surgery, but there was no legal guardian to consent. Again Charles did not know who to reach out to.

But Nemours connected him to Jacksonville Area Legal Aid, which had a program created just for cases like his. The Northeast Florida Medical Legal Partnership, which is now fundraising to build an endowment, helps about 200 local children a year who have medical problems that are complicated or exacerbated by legal issues. The partnership connected Charles to attorneys who, at no cost to him, established his guardianship, settled his mother's estate and helped get public benefits for the family.

"It took a load of stress, to say the least, off," he said, "making things easier for me to do what I set out to do in life."

The partnership was founded in 2002 by Jeffrey Goldhagen, then a pediatrician at the Florida Department of Health. Legal Aid received direct patient referrals from his agency, UF Health Jacksonville and the Sulzbacher Medical Clinic for the homeless.

Legal services included help accessing health insurance and other public benefits; education, housing and family law advocacy; consumer protection; and assistance with immigration issues.

"Legal advocacy is often critical to resolving those issues underlying a child's medical condition," said Jim Kowalski, Jacksonville Legal Aid president and CEO. "'By working together through the Northeast Florida Medical Legal Partnership, the medical and legal communities can be truly transformative in the lives of our community's kids."

In 2010 Legal Aid received a Florida Bar Foundation grant to add a pro bono component to the medical-legal partnership that would expand services through volunteer attorneys in addition to staff attorneys. Capacity increased by over 200 percent. Later other medical partners joined and the roster now has Wolfson Children's Hospital, Nemours Children's Specialty Care-Jacksonville, UF Health Specialty Pediatric Clinics Community PedsCare, a pediatric program of Community Hospice & Palliative Care. Also, on-site intake is available at the Sulzbacher Clinic and the VA Outpatient Clinic.

The partnership is funded by Baptist Health, the parent organization of Wolfson. But a planned endowment, announced in 2018, will provide funding in perpetuity. Legal Aid aims to raise $1 million over the next five years, with Baptist Health providing a 125 percent match to bring the total endowment to $2.25 million.

"We spend our life here chasing money to provide services," said Katy DeBriere, who was hired as the partnership's managing attorney in 2015. "With an endowment ... we can spend all our time helping people."

Legal Aid has raised $638,000 so far, with $365,000 from Baptist Health's match and $284,000 from private donations.

Not many partnership clients have as extensive a set of legal needs as Charles, she said.

"Amazing. What a remarkable story," she said. "There was a lot going on [with the family] at the time. He was just starting nursing school."

Nemours referred the Charles family to Legal Aid as a "challenging case," DeBriere said. But Marckly Charles and his circumstances touched many legal heartstrings, so had no difficulty arranging pro bono service.

"He was such an easy sell," she said.

Such referrals stemmed from the training Legal Aid has provided to hospital and clinic staff. They've been taught to spot legal issues that are negatively impacting children's health. Also, Legal Aid is giving staff additional training on specific legal topics, such as employment law and time-off rights of parents whose children have complex medical needs.

The extent of the program left Charles stunned. He was only sorry he had not heard about it earlier.

"I was surprised. I did not know it was possible," he said. "The help they provided, all of them, was great."

Charles, now 22, didn't have to give up his aspirations or the almost full scholarship he earned. He is on track to graduate from Florida State College at Jacksonville this summer and begin his career as a registered nurse. His preferred specialty is emergency room or trauma care.

His sister, Marie, now 21, is also in college working toward a nursing career as well. His brother, Kelly, 18, had surgery to repair his torn ACL, funded by Medicaid. With the help of physical therapy, he is now running again and, like his elder siblings, is aiming for a heath care career. The youngest sister, Neisha, 12, attends Darnell Cookman Middle-High School for the Medical Arts.

They are following the career example of their mother, who was a certified nurse assistant.

"She'd be proud," said Marckly Charles, briefly breaking down into tears. "She's pushing me on."

Beth Reese Cravey: (904) 359-4109

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